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Clubfoot deformity is a congenital condition typically seen at birth where an infant’s foot is positioned in a twisted down and inward position. This deformity affects both the muscles and the tissue, specifically affecting the tendons of the foot. Tendons connect muscles to bone, and these tissues are shortened in clubfoot. Clubfoot deformity is also known as talipes equinovarus. It affected males two times more than females. 50% of cases have club foot of both feet, known as bilateral clubfoot. In most children with clubfoot, the cause is unknown. There is a correlation of clubfoot in the following conditions: cerebral palsy, spina bifida, and breech positioning at birth.
How Is It Assessed
Clubfoot can be detected as early as 20 weeks during pregnancy through ultrasound or a child may be diagnosed at birth with this condition.
Orthopedic surgeons have developed a method of casting and bracing, known as the Ponsetti Method, to help correct clubfoot deformity without surgical intervention. Both phases of treatment are explained in more detail below.
Serial Casting: Physicians have developed a method of flexible casting known as serial casting. The first cast is placed a week or two after birth. The baby then returns to the surgeon one time a week for gentle ranging and stretching of their foot as well as placement of a new cast. Each new cast increases the amount the foot is turned outward for gradual correction. A standard plan of care for serial casting is about 5-7 different for a period of weeks to months.
Bracing: When the foot is in the correct position, the orthopedic surgeon will fit the baby with a brace (also called an “orthotic”) instead of a cast. The brace is a bar with special shoes or boots at each end. It keeps the foot from twisting back to where it was before the casting. Feet grow a lot and very quickly in the first years of life. Without the brace to keep a corrected clubfoot in the proper place, that rapid growth would send the foot back into the clubfoot position. Discuss boots & bar
For more severe forms of clubfoot that fail to correct with conservative interventions, surgery may be recommended by your child’s orthopedic surgery team.
Physical Therapy Management
Once your baby is recovered from any procedures performed and cleared to initiate physical therapy,